Power, care and knowledge: The co-construction of 'good mothering' in interactions between low-income mothers and child and family health nurses

In this study I explore how good mothering is negotiated and constructed between low-income mothers and child and family health (CFH) nurses. Mothers’ interactions with CFH nurses are an almost universal aspect of child-raising. The institutional role of CFH nurses is to support and guide mothers in raising their children within constructions of socially acceptable practice. Thus, the interaction is a site of regulation. Grounded in caring, nurses construct their role within a humanistic approach, focusing on care and empowerment, aiming for a collaborative relationship with mothers. This care (or relational) approach, however, sits in tension with their institutional (regulatory) role, particularly when constructions of good mothering are contested. Good mother ideologies are a powerful influence on the social regulation of mothers. Medico-scientific discourses, such as those around health and risk, shape the social constructions of mothers and mothering practices. Thus, alternative constructions of mothering – particularly non-middle-class and lay representations of motherhood - are marginalised, with some mothering practices compared unfavourably to elements of dominant good mother ideologies. This has implications for nurse-mother interactions as mothers’ knowledges can be subordinated to the expertise and knowledge of nurses. In this qualitative study I use Foucauldian concepts of power and adopt a constructionist and interpretive approach using observation and interview methods. The findings reveal firstly that nurses’ professional expertise and authority formed the basis of the relationships. However, mothers and nurses understanding of the role of expertise differed. Nurses were uncomfortable with using their knowledge and authority to direct mothers’ behaviours, as this may undermine the relationship, or claim to an ethic of care. Mothers, however, sought nurses primarily for their expertise rather than a personal relationship, although for some mothers the relationship was a source of interpersonal support. Mothers also resisted nurses’ authority to define good mothering practices by asserting their own definitions of good practices or good mother identity. Secondly, mothers and nurses implicitly reference good mother ideologies. Good mother identity was negotiated in both uncontested and contested ways. In uncontested negotiations, good mothering was affirmed or accomplished together. Where there was not a shared understanding of good mothering practices, nurses’ authority was resisted as mothers redefined good mothering practices by calling on their own authority and contextualised, experiential and child-specific knowledge. I argue that constructions of good mothering are negotiated within the encounters with both mothers and nurses calling on their own knowledges and expertise to come to a shared understanding of good mothering